论曰∶诸心腹痛者，或外邪来客，或气相干，其卒然痛而即止者，此寒气客于脉外，得
寒则缩蜷绌急，外引小络，得热即止，宜先用熨法，后以良姜散主之。
熨法《指南方》云∶治心腹痛，卒然而止，遇寒再发。
盐（半斤，炒极热）
上以旧帛包，熨痛处。 《指南方》云∶渐去至一重。
良姜散
高良姜（五两） 浓朴（去皮） 姜汁（涂，炙，二两） 当归 桂心（各三两）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。
若腰者肾之外候，足太阳经之流注。如痛连小腹，不得仰俯， 短气，由肾气虚
弱，有所不荣，补肾散主之。
补肾散
杜仲（去粗皮，杵碎，酒拌，炒焦，一两） 桂（去皮） 牡丹皮（各半两）
上为末。每服三钱，用猪肾一个，批开，糁药在内，入盐少许，以线扎定，水煮熟，空
心食之。
若隐隐腰痛，以热物熨痛处即少缓，由处卑湿，复为风邪伤足太阳之经，其脉缓涩，白
术散主之。
白术散
白术（二两） 芍药（三两） 桂（去皮） 附子（炮，去皮脐，各一两，锉）
上为细末。温酒调二钱匕，食前服。
若腰痛不能转侧，由劳役动伤经络，或从高堕下，气滞于腰，正气流行，相搏则痛，其
脉沉，大小不常，谓之 腰，趁痛丸主之。
趁痛丸（诸气门见趁痛散）
若腰如锥刀所刺，大便黑色，小便赤黑，此留血滞于腰间，谓之血沥腰痛，其脉涩，当
归丸主之。
当归丸
当归（三两，锉碎） 水蛭（好者，炒，三十个） 桃仁（去皮尖，三十个，炒，研）
上为末，酒糊为丸，如梧桐子大。酒下十粒，未知，加至三十粒。
若腰冷，腹重如带五千钱，如坐于水，由肾经为阴湿所逼，复受风冷，久不治，变成水
病，肾着汤主之。
肾着汤
甘草（炙） 干姜（各二两） 白茯苓 白术（各四两）
上为散。每服五钱，水二盏，煎至一盏，去滓，食前温服。
若腰脊不举，由远行劳倦，逢大热而渴，阳气内伐，热舍于肾，水不胜火，则骨枯而髓
减，盖阳明并肾，则肾脂枯。而宗筋主束骨而利机关也，是谓骨痿，菟丝子丸、补肾散主之
菟丝子丸
菟丝子（拣净，酒浸透，捣烂，焙干，二两） 牛膝（酒浸，一两） 杜仲（去粗皮，
杵碎
，酒拌一宿，炒焦，三两） 干地黄（焙，二两） 萆 （一两）
上为细末，炼蜜为丸，如梧桐子大。饮下三十粒，食后服。
补肾散（见前。）
若胁痛不得息，痛则咳而汗出，由邪客于足少阳之络，属胆。宜灸足小指次指爪甲上与
肉交处七壮，窍阴二穴也。
若臂外 痛，手不及头，心烦喉痹者，以邪客于手少阳之络，以针刺手大指次指之端，
去爪甲如韭叶，令血出而止。
若臂痛不能屈伸，此邪客于臂掌之间，取腕踝骨后，以指按之极痛，刺之留二呼，急出
针，或灸。
若筋拘挛，背急痛，引胁下，从项推下夹脊，按之应手痛者，于其上灸七壮，未定，加
至十四壮。
若痛引小腹，由寒气客于厥阴之脉，或胁肋相引，肾肝脉弦大，久成寒疝，桂枝乌头汤
主之。
桂枝乌头汤
桂心（三两） 芍药（三两） 乌头（炮，去皮脐，二两半） 甘草（炙，二两）
上为散。每服五钱，水二盏，姜五片，枣一枚，同煎至一盏，去滓，入蜜半匙许，再煎
一二沸，稍热服。
论述说：各种心腹疼痛，有的是外邪侵袭，有的是气机相互干扰。那些突然发作疼痛随即停止的，这是寒气客居在经脉之外，遇到寒冷则经脉收缩蜷曲、拘急，向外牵引细小的络脉，得到温热则疼痛停止，适宜先用熨法治疗，随后用良姜散主治。
熨法：《指南方》记载：治疗心腹疼痛，突然发作随即停止，遇寒冷再次复发。
盐（半斤，炒至极热）
以上述旧布包裹，熨烫疼痛部位。《指南方》记载：逐渐去掉包裹层，直至只剩一层布。
良姜散
高良姜（五两） 浓朴（去皮） 姜汁（涂抹后炙烤，二两） 当归 桂心（各三两）
以上药物研为散剂。每次服用五钱，加水两盏，煎煮至一盏，去渣，温服。
如果腰部疼痛，腰是肾的外候，也是足太阳经气血流注之处。如疼痛牵连小腹，不能仰卧或俯身，呼吸短促，这是由于肾气虚弱，有所失养，用补肾散主治。
补肾散
杜仲（去除粗皮，捣碎，酒拌，炒焦，一两） 桂（去皮） 牡丹皮（各半两）
以上药物研为末。每次服用三钱，取猪肾一个，剖开，将药粉撒入其中，加入少许盐，用线扎紧，用水煮熟，空腹食用。
如果是隐隐作痛的腰痛，用热物熨烫疼痛部位即可稍缓解，这是由于地处卑湿，又受风邪损伤足太阳经，其脉象缓涩，用白术散主治。
白术散
白术（二两） 芍药（三两） 桂（去皮） 附子（炮制，去皮脐，各一两，锉碎）
以上药物研为细末。用温酒调服二钱匕，饭前服用。
如果腰痛导致身体不能转侧，这是由于劳役损伤经络，或者从高處坠落，气滞于腰部，正气流行与邪气相搏结则产生疼痛，其脉象沉，大小不一，称为“腰”，用趁痛丸主治。
如果腰痛如锥刀刺割，大便黑色，小便赤黑，这是瘀血滞留于腰间，称为“血沥腰痛”，其脉象涩，用当归丸主治。
当归丸
当归（三两，锉碎） 水蛭（好的，炒，三十个） 桃仁（去皮尖，三十个，炒，研碎）
以上药物研为末，用酒糊制作成丸，如梧桐子大。酒送服十粒，若无效，加至三十粒。
如果腰部发冷，腹部沉重如系五千铜钱，如同坐在水中，这是由于肾经受阴湿逼迫，又感受风冷，久治不愈，变成水病，用肾着汤主治。
肾着汤
甘草（炙） 干姜（各二两） 白茯苓 白术（各四两）
以上药物研为散剂。每次服用五钱，加水两盏，煎煮至一盏，去渣，饭前温服。
如果腰脊僵硬不能抬起，这是由于远行劳倦，逢大热而口渴，阳气内伐，热邪舍于肾，水不胜火，则骨骼枯槁而髓液减少，因为阳明经与肾相连，则肾脂枯竭。而宗筋主束骨而利关节，这称为“骨痿”，用菟丝子丸、补肾散主治。
菟丝子丸
菟丝子（拣净，酒浸透，捣烂，焙干，二两） 牛膝（酒浸，一两） 杜仲（去粗皮，杵碎，酒拌一宿，炒焦，三两） 干地黄（焙，二两） 萆薢（一两）
以上药物研为细末，炼蜜为丸，如梧桐子大。饮送服三十粒，饭后服用。
补肾散（见前文。）
如果胁痛导致无法呼吸，疼痛时咳嗽且出汗，这是由于邪气客居在足少阳之络，属于胆经。适宜灸足小指次指爪甲上与肉交处七壮，即窍阴二穴。
如果手臂外侧疼痛，手举不到头，心烦喉痹，这是由于邪气客居在手少阳之络，针刺手大指次指之端，距离爪甲如韭菜叶宽处，令出血即止。
如果手臂疼痛不能屈伸，这是邪气客居在臂掌之间，取腕踝骨后方，用手指按压感到极度疼痛处，针刺留针两个呼吸的时间，迅速出针，或者艾灸。
如果筋脉拘挛，背部紧急疼痛，牵引胁下，从颈部向下沿夹脊，按压时应手而痛者，在其上方灸七壮，未痊愈，加至十四壮。
如果疼痛牵引小腹，这是由于寒气客居在厥阴之脉，或者胁肋相互牵引，肾肝脉弦大，久则形成寒疝，用桂枝乌头汤主治。
桂枝乌头汤
桂心（三两） 芍药（三两） 乌头（炮制，去皮脐，二两半） 甘草（炙，二两）
以上药物研为散剂。每次服用五钱，加水两盏，生姜五片，大枣一枚，同煎至一盏，去渣，加入蜂蜜半匙许，再煎一二沸，稍热服用。
Discourse states: Various epigastric and abdominal pains may be caused by the invasion of external pathogens or by mutual interference of Qi. Those that suddenly occur and cease immediately are due to Cold pathogen lodging outside the vessels; upon exposure to Cold, the vessels contract, curl, and become tense, pulling on the small collaterals externally, while relief is obtained with Heat. It is appropriate to first apply the moxibustion-warming method (Wen Fa), followed by treatment with Gao Liang Jiang San (Galangal Powder).
Warming Method (Wen Fa): The *Zhi Nan Fang* (Guide to the Compass) records: Treats epigastric and abdominal pain that occurs suddenly and ceases, recurring upon exposure to Cold.
Salt (half a jin, stir-fried until extremely hot)
Wrap the above in an old cloth and apply heat to the painful area. The *Zhi Nan Fang* records: Gradually remove layers until only one layer remains.
Gao Liang Jiang San (Galangal Powder)
Gao Liang Jiang (Alpiniae Officinarum Rhizoma, five liang) Hou Po (Magnoliae Officinalis Cortex, peeled) Jiang Zhi (Ginger Juice, applied then roasted, two liang) Dang Gui (Angelicae Sinensis Radix) Gui Xin (Cinnamomi Ramulus, three liang each)
Grind the above into powder. Take five qian per dose, add two zhan of water, decoct until one zhan remains, strain, and take warm.
If lower back pain occurs, the waist is the external manifestation of the Kidney and the pathway of flow for the Foot-Taiyang Meridian. If pain radiates to the lower abdomen, accompanied by inability to lie flat or bend forward, and shortness of breath, this is due to Kidney Qi deficiency and lack of nourishment; treat with Bu Shen San (Kidney Tonifying Powder).
Bu Shen San (Kidney Tonifying Powder)
Du Zhong (Eucommiae Cortex, remove coarse skin, crush, mix with wine, roast until scorched, one liang) Gui (Cinnamon Bark, peeled) Mu Dan Pi (Moutan Cortex, half liang each)
Grind the above into powder. Take three qian per dose, use one pig kidney, slice open, sprinkle medicine inside, add a little salt, tie securely with thread, boil in water until cooked, and eat on an empty stomach.
If there is dull lower back pain that relieves slightly with heat application to the painful area, this is due to dwelling in damp-low places combined with Wind pathogen injuring the Foot-Taiyang Meridian; the pulse is slow and choppy; treat with Bai Zhu San (Atractylodis Macrocephalae Powder).
Bai Zhu San (Atractylodis Macrocephalae Powder)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, two liang) Shao Yao (Paeoniae Radix Alba, three liang) Gui (Cinnamon Bark, peeled) Fu Zi (Aconiti Lateralis Radix Praeparata, processed, remove coarse skin and navel, one liang each, chopped)
Grind the above into fine powder. Mix two qian bi with warm wine and take before meals.
If lower back pain prevents turning the body, this is due to labor injury damaging the meridians, or falling from height causing Qi stagnation in the waist; when healthy Qi circulates and contends with pathogenic factors, pain results; the pulse is deep and irregular in size; this is called "Waist [Pain]", treat with Chen Tong Wan (Pain-Relieving Pill).
Chen Tong Wan (Pain-Relieving Pill) (See Chen Tong San for Qi mechanisms).
If lower back pain feels like stabbing with awls or knives, with black stool and dark red-black urine, this is stasis blood lodged in the waist, called "Blood Dripping Lower Back Pain"; the pulse is choppy; treat with Dang Gui Wan (Angelica Pill).
Dang Gui Wan (Angelica Pill)
Dang Gui (Angelicae Sinensis Radix, three liang, chopped) Shui Zhi (Hirudo, good quality, roasted, thirty) Tao Ren (Persicae Semen, remove skin and tip, thirty, roasted, ground)
Grind the above into powder, make pills with wine paste, sized like wutong seeds. Take ten pills with wine; if ineffective, increase to thirty pills.
If the waist feels cold, and the abdomen feels heavy as if bound with five thousand coins, as if sitting in water, this is due to the Kidney Meridian being constrained by Yin-Damp and further affected by Wind-Cold; if untreated for long, it transforms into Water Disease; treat with Shen Zhuo Tang (Kidney Fixing Decoction).
Shen Zhuo Tang (Kidney Fixing Decoction)
Gan Cao (Licorice Root, roasted) Gan Jiang (Zingiberis Rhizoma, two liang each) Bai Fu Ling (Poria, four liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma, four liang)
Grind the above into powder. Take five qian per dose, add two zhan of water, decoct until one zhan remains, strain, and take warm before meals.
If the lumbar spine cannot extend, this is due to exhaustion from long walking, encountering intense heat and thirst, where Yang Qi invades internally, Heat lodges in the Kidney, Water fails to control Fire, leading to dry bones and reduced marrow; since the Yangming Meridian connects with the Kidney, Kidney essence dries up. Since the Zong Jin (Tendon Sheath) binds bones and facilitates joint movement, this is called Bone Wei (Bone Atrophy); treat with Tu Si Zi Wan (Cuscuta Pill) and Bu Shen San (Kidney Tonifying Powder).
Tu Si Zi Wan (Cuscuta Pill)
Tu Si Zi (Cuscutae Semen, selected clean, soaked in wine until permeated, pounded, dried, two liang) Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, one liang) Du Zhong (Eucommiae Cortex, remove coarse skin, crush, soak in wine overnight, roast until scorched, three liang) Gan Di Huang (Rehmanniae Radix Preparata, dried, two liang) Bi Xie (Dioscoreae Hypoglaucae Rhizoma, one liang)
Grind the above into fine powder, make pills with refined honey, sized like wutong seeds. Take thirty pills with water after meals.
Bu Shen San (Kidney Tonifying Powder) (See previous section).
If hypochondriac pain prevents breathing, with coughing and sweating during pain, this is due to pathogen lodging in the Foot-Shaoyang Collateral, belonging to the Gallbladder. It is appropriate to moxa seven moxibustion cones at the junction of nail and flesh on the fourth toe, Qiaoyin (GB44) acupoint.
If lateral arm pain prevents raising the hand to the head, accompanied by irritability and throat obstruction, this is due to pathogen lodging in the Hand-Shaoyang Collateral; prick the end of the second finger, distance from nail edge like a leek leaf, until bleeding stops.
If arm pain prevents flexion and extension, this is due to pathogen lodging between the arm and palm; locate the point posterior to the wrist/ankle bone, press until extreme pain is felt, needle and retain for two breaths, withdraw quickly, or apply moxibustion.
If tendons are spasmodic, with urgent back pain radiating to the hypochondrium, descending from the neck along the paravertebral region, tender to touch; apply seven moxibustion cones above the site; if unresolved, increase to fourteen cones.
If pain radiates to the lower abdomen, this is due to Cold pathogen lodging in the Jueyin Meridian, or radiating hypochondriac pain; Kidney and Liver pulses are wiry and large; long-term development forms Han Shan (Cold Hernia); treat with Gui Zhi Wu Tou Tang (Cinnamon Twig and Aconite Decoction).
Gui Zhi Wu Tou Tang (Cinnamon Twig and Aconite Decoction)
Gui Xin (Cinnamomi Ramulus, three liang) Shao Yao (Paeoniae Radix Alba, three liang) Wu Tou (Aconiti Radix, processed, remove coarse skin and navel, two and a half liang) Gan Cao (Licorice Root, roasted, two liang)
Grind the above into powder. Take five qian per dose, add two zhan of water, five slices of ginger, one jujube, decoct together until one zhan remains, strain, add half a spoonful of honey, boil for one or two more boils, and take slightly warm.